Medicare Advantage Part D pharmacy benefits

For plan members in Illinois and Missouri

Medications play a significant role in your health care

The following information from Medica Central Health Plan will help guide your decisions about medications and answer questions about your Medicare pharmacy benefits.

Need help paying for prescriptions?

You may be able to get extra help to pay for your prescription drug premiums and costs. To see if you qualify for extra help, call:


Utilization management for prescription drugs

Some covered medications have additional requirements – like a prior authorization requirement or coverage limits. See requirements and access prior authorization forms.

Vaccine coverage

See how some vaccines are covered under the Part D benefit and when vaccines are covered under Medicare Part B.

Pharmacy benefit guidelines Q&A

Read common questions and answers about Medicare pharmacy Part D topics. 

Drug overutilization review program

See how we meet the CMS requirement to prevent clinically inappropriate overuse of opioid medicines and acetaminophen.

Medication therapy management program

Read about our medication therapy management program.

Pharmacy transition process

Learn about our pharmacy transition process when you:
  • are a new member
  • are a returning member
  • change care locations
  • have other special circumstances.

Coverage determinations, exceptions, appeals & grievances

Learn more about Part D appeals, grievances, exceptions and coverage determinations.

Contact Member Services if you need additional information, including:

  • How we control the use of services and costs
  • The number of appeals and grievances filed by our members
  • A summary description of how we pay our doctors
  • A description of our financial condition, including a summary of our most recent audit statement

Contact us

View our Medicare disclaimer.
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